Medication dispensing apparatus

ABSTRACT

A medication dispenser provides automation to the steps of locating and acquiring medications or supplies to be administered to a patient. The medication dispenser includes one or more modules housing one or more compartmentalized drawers. Access to each drawer is controlled by a lockable door, and each the drawer may only be slid from the module housing the drawer in response to a signal. A series of lights direct the user to the appropriate drawer and the appropriate compartment of the relevant drawer to remove the appropriate medication or supply.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.60/891,417, filed Feb. 23, 2007, which is herein incorporated byreference in its entirety.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

Not Applicable

BACKGROUND

As reported by the Institute of Medicine, an estimated 106,000 deathsoccurred in 1994 due to adverse drug reactions (ADRs), and more than2,000,000 hospitalized patients experienced serious, if not fatal, ADRs.Lazarou J. et al., Incidence of adverse drug reactions in hospitalizedpatients: a meta-analysis of prospective studies, J. Am. Med. Assn.1998: 279: 1200-1205. Many of these errors are attributable to thesystems and methods used to store and deliver medications to thoseclinicians providing care to patients. Various solutions have beenproposed to address the issue of medication delivery errors. Forinstance, computerized systems ensure that the medication ordered orprescribed by the clinician is clinically appropriate. These systems mayverify that the dosage is proper based on patient information such asweight and evidence based guidelines or protocols. Also, these systemsmay perform interaction checking against other medications. However,even if the clinician orders an acceptable medication and dosage amountfor a specific patient, the actual drug and/or dosage administered tothe patient may vary from what was requested. A pharmacist or otherclinician may accidentally provide an improper drug or drug dosage ifthe order is not properly communicated and followed at each step in theclinical process. Errors may also occur during the steps of themedication administration process occurring between the pharmacy and thepoint of care. Existing systems and methods for physically transferringand storing and electronically tracking medications and supplied havebeen employed include automated dispensing machines (ADMs). Toadminister a medication to a patient, a nurse or other clinicianretrieves the appropriate medication from one of a number of ADMslocated throughout the healthcare facility. In addition to failing toprevent medication errors, existing systems and methods employing ADMsare wasteful and oftentimes difficult to use. The same issues apply whendispensing supplies.

SUMMARY

This summary is provided to introduce a selection of concepts in asimplified form that are further described below in the DetailedDescription. This summary is not intended to identify key features oressential features of the claimed subject matter, nor is it intended tobe used as an aid in determining the scope of the claimed subjectmatter.

Embodiments of the present invention are directed to an automatedmedication dispenser. A medication dispenser provides automation to thesteps of locating and acquiring medications or supplies to beadministered to a patient or used during patient care. The medicationdispenser includes one or more modules housing one or morecompartmentalized drawers. Access to each drawer is controlled by alockable door, and each drawer may only be slid from the module housingthe drawer in response to a signal. A series of lights direct the userto the appropriate drawer and the appropriate compartment of therelevant drawer to remove the appropriate medication or supply.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

In the accompanying drawings, which form a part of the specification andare to be read in conjunction therewith and in which like referencenumerals are employed to indicate like parts in the various views:

FIG. 1 is a front perspective view of a medication dispenser inaccordance with an embodiment of the present invention;

FIG. 2 is a front perspective view of a medication dispenser inaccordance with an embodiment of the present invention having a frontdoor opened to provide access to the drawers;

FIG. 3 is a front perspective view of a medication dispenser inaccordance with an embodiment of the present invention having a frontdoor opened and one drawer in an open position;

FIG. 4 is a rear perspective view of a medication dispenser inaccordance with an embodiment of the present invention with sectionsremoved to demonstrate the construction and assembly of the modules ofthe medication dispenser;

FIG. 5 is a side perspective view of a medication dispenser inaccordance with an embodiment of the present invention with sectionsremoved to demonstrate the assembly of the modules of the medicationdispenser; and

FIG. 6 is a block diagram of an exemplary medication informationcomputing environment suitable for use in implementing the presentinvention.

DETAILED DESCRIPTION

With reference to the drawings, wherein like reference charactersdesignate like parts throughout the different views, a medication andsupply dispenser according to an embodiment of the present invention isdesignated generally with the reference numeral 10. The medicationdispenser 10 generally includes a footer plate 12, a number of modules14 and a header plate 16, as depicted in FIGS. 1-5. The modules 14 aredisposed in a vertical stack, and each module contains a number ofcompartmentalized drawers 18 for storing and dispensing medical itemswhich may include, for instance, medications in syringes, ampules,vials, oral suspensions, tubes, jars, oral solids and other packagingoptions, as well as a variety of medical supplies and other materialsused in the provision of healthcare.

Each module 14 provides a controlled environment in which medicationsare stored. Each module 14 includes a front door 20 (that may be lockedto regulate access to the drawers 18), side walls 22, a rear wall 24, atop 26, and a bottom 28. In some embodiments, a refrigeration unit (notshown) may be coupled with one or more of the modules 14, which may bedesirable to avoid spoilage of certain types of medication.

Each front door 20 is lockable to limit access to only authorizedclinicians. The door is hinged to one of the sidewalls 22 to rotatebetween a closed position as shown in FIG. 1 and an open position inFIG. 2. As shown in FIG. 1, each front door includes an opening 30within which a window 32 is fixed. The window is transparent and allowsa user to view a portion of each drawer as set forth in detail below.

When the front door is open, access is provided to the drawers 18. Eachdrawer 18 may be slid from the module associated with the drawer whenthe front door 20 is open and the lock (not shown) for the particulardrawer is unlocked. Specifically, when unlocked, a handle 33 of thedrawer 18 may be grasped by the user to slide the drawer to an openposition to allow access to a number of compartments 34 defined with thedrawer 18. The medications, supplies and other materials are storedwithin the compartments. Also, as described in operation below, eachdrawer includes a signal light 36, and a number of selection lights 38associated with each compartment 34. In embodiments, the signal lights36 and selection lights 38 are electronically coupled with a mastercircuit board and a power source (not shown) disposed in the headerplate 16. As shown in FIG. 4, energy chains 40 are employed to house thecabling connecting the signal lights 36 and selection lights 38 in thedrawers, and move along horizontally along with the drawers 18 when thedrawers are opened and closed.

The modules 14 are configured to store multiple sized drawers 18 formedication storage and dispensing. For instance, referring to FIG. 1, asingle large drawer may be associated with a module for storingparticularly large items and equipment. Two drawers of equal ordiffering sizes may be associated with a particular module. Also, asillustrated in FIG. 2, three equally sized drawers may be housed withina module. It should be noted that drawer configurations different thanthose shown in FIGS. 1-5 may be employed in various embodiments of theinvention (e.g., different drawer sizes, different number of drawers,different compartment configurations, etc.).

In an embodiment of the invention, as shown in FIG. 1, four modules 14are stacked between the footer plate 12 and the header plate 16. Withreference to FIG. 5, each module 14 includes a placement handle 48. Themodules 14 are aligned to one another by a series of locating pins 42extending from the top 26 of the lower module, and received within thebottom 28 of the upper module. Once located, a series of bolts 44 securethe modules one to another. The lowest module and the footer plate, andthe uppermost module and the header plate, may be secured to one anotherin a similar manner. A series of cover strips 46 are secured on theexterior of the sidewalls 22 where each module is connected to anothermodule, the header plate or the footer plate. In embodiments, the coverstrips 46 are made of plastic, and overlay the seams to provide aunitary look to the device 10. Any number of modules 14 may be employedfrom a single module to a stack of four or more modules. The designallows a common construction for high volume areas of a hospitalrequiring a stack of multiple modules and lower volume areas of a healthcare provider in which a single module may effectively serve thepopulation of recipients of care.

Referring again to FIG. 3, to stock the medication dispenser 10, medicalitems such as, for example, medications are initially placed intocompartments 34. When medical items are placed into each compartment 34,the medical items and compartments 34 are identified to a computersystem, which associates the medical items with their correspondingcompartments 34. For instance, a compartment 34 may be identified to thecomputer system by reading a bar code located on, or associated with,the compartment 34 or by manually entering a compartment identifier.Similarly, in some embodiments, each medication or supply may beprovided in a package having an identification marking, such as a barcode, an RFID tag, or some other identifier. A medical item may then beidentified to the computer system by reading the bar code or RFID taglocated on the medication package or by manually entering an identifierassociated with the medical item.

After medications or supplies have been placed into compartments 34, thedrawers 18 are slid into the closed position, and locked into place bylocks (not shown) in electrical connection with the master circuit boardand a power source (not shown) disposed in the header plate 16. Thefront doors 20 are also closed and locked.

When a medication or supply is to be dispensed from the medicationdispenser 10, a medication or supply is initially selected, forinstance, by a clinician interacting with a computer system associatedwith the medication dispenser 20. The computer system accessesinformation associating medications or supplies with the location of themedication or supply. Specifically, the computer system determines thelocation of the module 14, drawer 18 and compartment 34 within which therelevant item is located. Next, the computer system communicates to theprocessor located in the header plate 16. The processor sends a signalto illuminate the signal light 26 of the appropriate drawer from whichan item is to be retrieved. The user can visually identify the signallight 26 through the window 32. Also, in response to the signal, thefront door 20 of the module within which the desired medication orsupply is located is unlocked. The lock to the appropriate drawer 18 isunlocked, too, and drawer 18 with the illuminated signal light 26 ispulled open to the position as shown in FIG. 3. The processor also sendsa signal to illuminate the appropriate selection light 38 to direct tothe user to the appropriate compartment 34 in the appropriate drawer 18.In an embodiment, the process is repeated until each of the relevantmedications and supplies are removed from the device 10. In someembodiments, multiple selection lights and signal lights may beilluminated simultaneously to allow the user to remove multiple items.In embodiments, the user may provide feedback to the computer system toverify that a specific medication or supply has been removed from thedevice.

As indicated previously, a computer system is provided for controllingthe operation of the medication dispenser 10. In some embodiments, thecomputer system includes a computing device dedicated to the medicationdispenser 10. The medication dispenser computing device may receiveinputs, such as inputs associated with loading and medication-dispensingoperations. Based on the inputs, the medication dispenser computingdevice controls the processor of device 10 and thus the locks, signallights and selection lights of the present invention.

In some embodiments, the medication dispenser computing device may actas a stand-alone device such that the medication dispenser computingdevice maintains all data necessary for operating the medicationdispensing operations of the medication dispenser 10. In otherembodiments, however, the medication dispenser computing device operateswithin a distributed clinical computing environment. In particular, themedication dispenser computing device may be interfaced with orintegrated into a medical information computer system. The medicalinformation computing system may be a comprehensive computing systemwithin a clinical environment such as the exemplary medical informationcomputing system environment 200 shown in FIG. 20. It will be understoodand appreciated by those of ordinary skill in the art that theillustrated medical information computing system environment 200 ismerely an example of one suitable computing environment and is notintended to suggest any limitation as to the scope of use orfunctionality of the invention. Neither should the medical informationcomputing system environment 202 be interpreted as having any dependencyor requirement relating to any single component or combination ofcomponents illustrated therein.

Embodiments of the present invention may be operational with numerousother general purpose or special purpose computing system environmentsor configurations. Examples of well-known computing systems,environments, and/or configurations that may be suitable for use withthe present invention include, by way of example only, personalcomputers, server computers, hand-held or laptop devices, multiprocessorsystems, microprocessor-based systems, set top boxes, programmableconsumer electronics, network PCs, minicomputers, mainframe computers,distributed computing environments that include any of theabove-mentioned systems or devices, and the like.

Embodiments of the present invention may be described in the generalcontext of computer-executable instructions, such as program modules,being executed by a computer. Generally, program modules include, butare not limited to, routines, programs, objects, components, and datastructures that perform particular tasks or implement particularabstract data types. Embodiments of the present invention may also bepracticed in distributed computing environments where tasks areperformed by remote processing devices that are linked through acommunications network. In a distributed computing environment, programmodules may be located in local and/or remote computer storage mediaincluding, by way of example only, memory storage devices.

With continued reference to FIG. 6, the exemplary medical informationcomputing system environment 200 includes a general purpose computingdevice in the form of a server 202. Components of the server 202 mayinclude, without limitation, a processing unit, internal system memory,and a suitable system bus for coupling various system components,including database cluster 204, with the server 202. The system bus maybe any of several types of bus structures, including a memory bus ormemory controller, a peripheral bus, and a local bus, using any of avariety of bus architectures. By way of example, and not limitation,such architectures include Industry Standard Architecture (ISA) bus,Micro Channel Architecture (MCA) bus, Enhanced ISA (EISA) bus, VideoElectronic Standards Association (VESA) local bus, and PeripheralComponent Interconnect (PCI) bus, also known as Mezzanine bus.

The server 202 typically includes, or has access to, a variety ofcomputer readable media, for instance, database cluster 204. Computerreadable media can be any available media that may be accessed by server202, and includes volatile and nonvolatile media, as well as removableand non-removable media. By way of example, and not limitation, computerreadable media may include computer storage media and communicationmedia. Computer storage media may include, without limitation, volatileand nonvolatile media, as well as removable and nonremovable mediaimplemented in any method or technology for storage of information, suchas computer readable instructions, data structures, program modules, orother data. In this regard, computer storage media may include, but isnot limited to, RAM, ROM, EEPROM, flash memory or other memorytechnology, CD-ROM, digital versatile disks (DVDs) or other optical diskstorage, magnetic cassettes, magnetic tape, magnetic disk storage, orother magnetic storage device, or any other medium which can be used tostore the desired information and which may be accessed by the server202. Communication media typically embodies computer readableinstructions, data structures, program modules, or other data in amodulated data signal, such as a carrier wave or other transportmechanism, and may include any information delivery media. As usedherein, the term “modulated data signal” refers to a signal that has oneor more of its attributes set or changed in such a manner as to encodeinformation in the signal. By way of example, and not limitation,communication media includes wired media such as a wired network ordirect-wired connection, and wireless media such as acoustic, RF,infrared, and other wireless media. Combinations of any of the abovealso may be included within the scope of computer readable media.

The computer storage media discussed above and illustrated in FIG. 1,including database cluster 204, provide storage of computer readableinstructions, data structures, program modules, and other data for theserver 202.

The server 202 may operate in a computer network 206 using logicalconnections to one or more remote computers 208. Remote computers 208may be located at a variety of locations in a medical or researchenvironment, for example, but not limited to, clinical laboratories,hospitals and other inpatient settings, veterinary environments,ambulatory settings, medical billing and financial offices, hospitaladministration settings, home health care environments, and clinicians'offices. Clinicians may include, but are not limited to, a treatingphysician or physicians, specialists such as surgeons, radiologists,cardiologists, and oncologists, emergency medical technicians,physicians' assistants, nurse practitioners, nurses, nurses' aides,pharmacists, dieticians, microbiologists, laboratory experts, geneticcounselors, researchers, veterinarians, students, and the like. Theremote computers 208 may also be physically located in non-traditionalmedical care environments so that the entire health care community maybe capable of integration on the network. The remote computers 208 maybe personal computers, servers, routers, network PCs, peer devices,other common network nodes, or the like, and may include some or all ofthe components described above in relation to the server 202. Thedevices can be personal digital assistants or other like devices.

Exemplary computer networks 206 may include, without limitation, localarea networks (LANs) and/or wide area networks (WANs). Such networkingenvironments are commonplace in offices, enterprise-wide computernetworks, intranets, and the Internet. When utilized in a WAN networkingenvironment, the server 202 may include a modem or other means forestablishing communications over the WAN, such as the Internet. In anetworked environment, program modules or portions thereof may be storedin the server 202, in the database cluster 24, or on any of the remotecomputers 208. For example, and not by way of limitation, variousapplication programs may reside on the memory associated with any one ormore of the remote computers 208. It will be appreciated by those ofordinary skill in the art that the network connections shown areexemplary and other means of establishing a communications link betweenthe computers (e.g., server 202 and remote computers 208) may beutilized.

In operation, a user may enter commands and information into the server202 or convey the commands and information to the server 202 via one ormore of the remote computers 208 through input devices, such as akeyboard, a pointing device (commonly referred to as a mouse), atrackball, or a touch pad. Other input devices may include, withoutlimitation, microphones, satellite dishes, scanners, or the like.Commands and information may also be sent directly from a remotehealthcare device to the server 202. In addition to a monitor, theserver 202 and/or remote computers 208 may include other peripheraloutput devices, such as speakers and a printer.

Although many other internal components of the server 202 and the remotecomputers 208 are not shown, those of ordinary skill in the art willappreciate that such components and their interconnections are wellknown. Accordingly, additional details concerning the internalconstruction of the server 202 and the remote computers 208 are notfurther disclosed herein.

By interfacing and/or integrating a medication dispensing computingdevice with a comprehensive medical information computing system, suchas the medical information computing system 200 of FIG. 6, a number ofadvantages may be realized. For example, the medication dispensingclinical device may be interfaced with or otherwise access computingdevices and/or computing systems in a variety of different clinicaldomains within a healthcare environment. By way of example only and notlimitation, the medical information computing system 200 may include aclinical laboratory system, a pharmacy system, a radiology system, and ahospital administration system. Accordingly, the medical informationcomputing system 200 provides a unified computing architecture that isable to access and aggregate clinical information from a variety ofdifferent clinical domains and make the clinical information availableto the medication dispensing computing device. In an embodiment, themedical information computing system 200 may store clinical informationfrom different clinical domains in a patient-centric electronic medicalrecord (including an electronic medication administration record)accessible to multiple devices within the system 200, including themedication dispensing computing device. Accordingly, medicationdispensing may be automated and clinician workflow may be supported frommedication prescribing through medication dispensing and administration.As such, a closed process may be provided that delivers increasedpatient safety throughout the medication process, greater speed in themedication dispensing process, and improved efficiency for clinicians.

The present invention has been described in relation to particularembodiments, which are intended in all respects to be illustrativerather than restrictive. Alternative embodiments will become apparent tothose of ordinary skill in the art to which the present inventionpertains without departing from its scope. Substitutions may be made andequivalents employed herein without departing from the scope of theinvention as recited in the claims. It will be understood that certainfeatures and subcombinations are of utility and may be employed withoutreference to other features and subcombinations. This is contemplatedand within the scope of the claims.

1. A method for dispensing medications and supplies, the methodcomprising: providing at least one module, the at least one modulehaving a lockable door with a transparent window disposed therein, atleast one drawer having a signal light attached to a front side of thedrawer so that the signal light is visible through the transparentwindow when the door is in a closed position, and at least onecompartment defined within each drawer; receiving a user selection of amedical item, the user selection comprising an item identifiercorresponding to the selected medical item; determining a locationidentifier associated with the item identifier, wherein the locationidentifier corresponds to a compartment in which the selected medicalitem is located; illuminating the signal light associated with thedrawer containing the compartment in which the selected medical item islocated; and providing access to the compartment in which the selectedmedical item is located, wherein providing access comprises unlockingthe module door.
 2. The method of claim 1, wherein the at least onemodule comprises a plurality of modules.
 3. The method of claim 2,wherein the plurality of modules comprises a vertical stack of two ormore modules.
 4. The method of claim 1, further comprising illuminatinga selection light associated with the compartment in which the selectedmedical item is located.
 5. The method of claim 1, further comprising acomputer system for providing access to the compartment in which theselected medical item is located.
 6. The method of claim 5, wherein thecomputer system comprises a dispenser computing device that maintainsdata necessary for providing access to medical items.
 7. The method ofclaim 5, wherein the dispenser computing device operates within adistributed clinical computing environment.